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Organization

HUERFANO LAS ANIMAS AREA COUNCIL OF GOVERNMENTS

Active
Other names
South Central Council of Governments
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WALTER BOULDEN (EXECUTIVE DIRECTOR)
(719) 845-1133
Entity
Organization

Contact information

Practice address
625 N POLK AVE, WALSENBURG, CO 81089-1549
(719) 738-2205
(719) 738-6898
Mailing address
625 N POLK AVE, WALSENBURG, CO 81089-1549
(719) 738-2205
(719) 738-6898

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
311ZA0620X
Adult Care Home Facility
10F196
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10F196
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
CO
05
19203314
CO
Enumeration date
02/07/2017
Last updated
07/08/2021
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